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伊朗在线医疗咨询的促进因素和障碍:一项使用CFIR框架探索医疗保健政策制定者和管理人员观点的定性研究

Facilitators and barriers to online medical consultation in Iran: a qualitative study exploring the perspectives of healthcare policymakers and administrators using the CFIR framework.

作者信息

Ghasempour Azadeh, Nojomi Marzieh, Goharinezhad Salime, SoleimanvandiAzar Neda, Rampisheh Zahra

机构信息

Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

School of Health and Care Management, Arden University, Arden House, Middlemarch Park, Coventry CV3 4FJ, UK.

出版信息

BMC Health Serv Res. 2025 Aug 13;25(1):1076. doi: 10.1186/s12913-025-13271-x.

Abstract

BACKGROUND

Online Medical Consultation (OMC) offers a promising avenue for improving healthcare access and efficiency in Iran. However, its integration into the national health system remains limited due to complex systemic, infrastructural, and regulatory challenges.

OBJECTIVE

This study uses the Consolidated Framework for Implementation Research (CFIR) to identify and analyze the key facilitators and barriers to OMC adoption in Iran from the perspectives of healthcare policymakers and administrators.

METHODS

This qualitative study employed semi-structured interviews with nine senior healthcare stakeholders. Data were analysed using inductive thematic coding, mapped onto CFIR domains, to systematically identify multilevel factors influencing OMC implementation.

RESULTS

Key facilitators included perceived advantages of access and efficiency, Adaptability across healthcare functions, Recipient-Centred Transparency and Accountability, urban digital readiness, and increased acceptance during the COVID-19 pandemic. Barriers were identified across multiple domains, including weak infrastructure, lack of legal frameworks, limited digital literacy, Tensions between patient satisfaction and clinical standards, and absence of stakeholder engagement.

CONCLUSION

OMC in Iran presents clear benefits but faces entrenched barriers requiring targeted policy, infrastructure, and educational interventions. Regulatory clarity, cross-sector governance, and integration with public systems are critical for sustainable scale-up.

摘要

背景

在线医疗咨询(OMC)为改善伊朗的医疗服务可及性和效率提供了一条充满希望的途径。然而,由于复杂的系统、基础设施和监管挑战,其融入国家卫生系统的程度仍然有限。

目的

本研究使用实施研究综合框架(CFIR),从医疗政策制定者和管理者的角度识别和分析伊朗采用OMC的关键促进因素和障碍。

方法

本定性研究对九名高级医疗利益相关者进行了半结构化访谈。使用归纳主题编码对数据进行分析,并映射到CFIR领域,以系统地识别影响OMC实施的多层次因素。

结果

关键促进因素包括可及性和效率方面的感知优势、跨医疗功能的适应性、以接受者为中心的透明度和问责制、城市数字准备情况以及在新冠疫情期间认可度的提高。在多个领域发现了障碍,包括基础设施薄弱、缺乏法律框架、数字素养有限、患者满意度与临床标准之间的紧张关系以及利益相关者参与度不足。

结论

伊朗的OMC有明显益处,但面临根深蒂固的障碍,需要有针对性的政策、基础设施和教育干预措施。监管明确、跨部门治理以及与公共系统整合对于可持续扩大规模至关重要。

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